Comorbid ADHD, conduct disorder explains link between autism, violence
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Autism was associated with an increased risk for violent crime; however, the association was significantly attenuated by comorbid ADHD or conduct disorder, according to recent findings.
“We know that some people with an autism diagnosis have challenging behavior and may come into contact with the criminal justice system; however, whether having autism increases the risk of violence or not has previously not been clear,” Ragini Heeramun, MRCPsych, LLM, of Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, United Kingdom, said in a press release. “Our findings, from the largest study to date, show that at the population level, autism in itself doesn't seem to be associated with convictions for violent crimes. However, other conditions, such as ADHD, which can co-occur with autism, may increase such risks.”
To determine associations between autism and convictions for violent crimes, researchers analyzed data from the Stockholm Youth Cohort for 295,734 individuals who were followed up from age 15 to 27 years. Of these, 5,739 individuals had autism.
Autism was associated with a higher risk for violent offending (adjusted RR = 1.39; 95% CI, 1.23-1.58). However, this association was significantly attenuated when accounting for co-occurring ADHD or conduct disorder (aRR = 0.85; 95% CI, 0.75-0.97).
Male sex and psychiatric conditions were the strongest predictors of violent criminality among individuals with autism, followed by parental criminal and psychiatric history and socioeconomic characteristics.
Researchers found some evidence that indicated a delayed autism diagnosis was associated with a greater risk for violent crime.
Better school performance and intellectual disability were protective factors.
“Interestingly, the additional presence of an autism diagnosis with ADHD or conduct disorder was actually associated with a relatively lower risk of convictions, compared to having these conditions without autism,” study researcher Dheeraj Rai, MRCPsych, PhD, of the University of Bristol, said in the release. “These findings are important for autism services, which often focus on providing a diagnosis of autism, rather than the identification of, and support for, the conditions that commonly occur alongside it.” – by Amanda Oldt
Disclosure: Please see the study for a full list of relevant financial disclosures.